Psychiatric medications, science, marketing, psychiatry in general, and occasionally clinical psychology. Questioning the role of key opinion leaders and the use of "science" to promote commercial ends rather than the needs of people with mental health concerns.

Monday, June 09, 2008

It appears that Joe Biederman, King of Child Bipolar, has been caught with his hands in the cookie jar. More specifically, the New York Times and Bloomberg have noted that Biederman has received a great deal of pharma cash (like at least $1.6 million dollars from 2000-2007) and has not been very forthcoming about such funds. How was such undercover money revealed? Courtesy of Charles Grassley, the Iowa Republican Senator whose prior investigation unearthed a similar situation impacting another Bipolar Child Key Opinion Leader, Melissa DelBello from the University of Cincinnati.

Here's one example, from Gardiner Harris and Benedict Carey at the New York Times:

In one example, Dr. Biederman reported no income from Johnson & Johnson for 2001 in a disclosure report filed with the university. When asked to check again, he said he received $3,500. But Johnson & Johnson told Mr. Grassley that it paid him $58,169 in 2001, Mr. Grassley found.

So Biederman is supposed to report outside income to the university, but he didn't. Then, his amended reports were in some instances a wild underestimate of his outside income. So how well is the "honor system" working out for conflicts of interest, anyway? To be fair, Biederman is not alone -- two other Harvard psychiatrists (Timothy Wilens and Thomas Spencer) had similar reporting problems. Indeed, there is nothing to say that Biederman's conflicts of interest are any more noteworthy than those of other "stars" in the academic psychiatry universe.

Worry not, Biederman is still interested in saving lives. He is recruiting 4 to 6 year olds with "bipolar disorder" for a Seroquel trial.

For some reason, I thought Biederman's prior comments were worth repeating here. From the Boston Globe:

Biederman dismisses most critics, saying that they cannot match his scientific credentials as co author of 30 scientific papers a year and director of a major research program at the psychiatry department that is top-ranked in the "US News & World Report" ratings.

"The critics 'are not on the same level. We are not debating as to whether [a critic] likes brownies and I like hot dogs. In medicine and science, not all opinions are created equal,' said Biederman, a native of Czechoslovakia who came to Mass. General in 1979 after medical training in Argentina and Israel. He now lives in Brookline.

You tell 'em, Joe! I suppose those who dare critique his conflicts of interest are "not on the same level" as him. Some say that we shouldn't be concerned about conflicts of interest, that we should just look at the quality of a person's work, regardless of financial conflicts. Well, Biederman is the undisputed King of Bipolar in kids, and I'm still awaiting any impressive outcome dataon the "bipolar" kids being treated with antipsychotics. Especially the young kids. 4 year olds on Seroquel-- I'm glad I'm not on Joe's level. Are we better off now that the diagnosis of bipolar has run rampant in kids?

That list of clinical trials should really give psychiatry enthusiasts pause. 8 week trial of Seroquel for 4-6 year olds? By the way, it's okay if you're already on stimulant meds -- you can keep taking them. So what are you supposed to do after 8 weeks? Keep taking Seroquel? Well, that has some known adverse effects to the body. Stop taking Seroquel? Good Luck there too -- might be in store for some heavy rebound manic and psychotic behavior if such a thing even exists in 4-6 year olds, but you can bet that whatever it's equivalent is in that age group it will get worse. Then there's the trial for Lamictal in 6-17 year olds -- it's okay to be on stimulants for that trial too. (Old Joe wouldn't want to deprive any of his sponsors of their business I'm sure.) My question is if it's okay to be in it if you also have a diagnosis of ADHD, OCD. CD (what the hey) what happens to the treatments you've undoubtedly been having for all those? Can you stay on those too like the stimulants or are you going to withdraw from them abruptly in a "wash out" phase so they can start the Lamictal in an acute state of withdrawal? That would be interesting to know. All kidding aside, the description of these trials makes my stomach turn. Just tragic for any kid that gets sucked into participating -- how little do they or their parents know what's really in store. It's all geared to have results that look good in the "honeymoon" phase of the first few weeks, but anyone who's been around psych drugs knows it doesn't last and creates havoc with body and soul. God save the children.

I found this blog through a link from Furious Seasons' site. After reading this posting, as a psychiatrist, all I can say is people like this, who I must sadly say is a colleague, get what is due, and that is this predator is exposed and humiliated for his incredibly poor judgment. At the end of the day, this isn't a misunderstanding, it is greed and selfishness, amen!

Arrogance and entitlement are traits that have NO PLACE in my field. I hope the consequences from this revelation include Mass Gen too.

The ignorance on the blogosphere regarding this issue is frightening. Utterly and completely frightening.

Too many people self-medicating with vitriole, poor thinking skills, and gotcha.

There is no willingness or ability to think, to examine other possible angles.

Only fools take as gospel the hit job of a grandstanding politician--one whose second-biggest donor is a health insurance company. Insurance companies have much to gain by denying these medications to children.

Shame on all of you. Shut down your blogs and go back to school. You are serving no purpose and only doing harm. Some of you should take your medications, too, and quit pestering people.

It is quite shocking and sad to see the state some of these 4 to 6 year old children are in when they come. I am working with a 6 year old now who HAS tried to kill herself multiple times.

We do need GOOD, UNTAINTED research, desperately. It can really help us treat these children. We also need people to understand and have some compassion for these children. Support health care parity that covers everyone- these parents usually lose their jobs after having to leave enough times to pick up a violent child from school.

Dr. Biederman is a wonderful doctor who has been an incredible help to my child and our family. Before you judge him so harshly, see this description of how Gardiner Harris of the New York Times has used tabloid journalism techniques to distort his record http://www.drugwonks.com/account_blog/row?_method=get&eid=789c52d2dc72851406c281b9eeab8ffc&id=6150 For the truth about Dr. Biederman, also see: http://www2.massgeneral.org/pediatricpsych/staff/biederman.html and http://en.wikipedia.org/wiki/Joseph_Biederman

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About Me

I'm an academic with a respectable amount of clinical experience and no drug industry funding. Given my lack of time, don't expect multiple daily updates. Certain things about clinical psychology, the drug industry, psychiatry, and academics drive me nuts, and you'll probably pick up on these pet peeves before long...